Push—Crash: Breaking the Cycle in Chronic Fatigue Syndrome

Marginal gains—for many top athletes using Omegawave, their training goals involve honing in on those razor-thin gaps that separate greatness from getting by. Every training day is maximized in order to shave a fraction of a second off a sprint time or strike a devastating ball in the 90th minute or fight on until the final bell. For John Falk, who has been battling Chronic Fatigue Syndrome (CFS) for nearly a decade, the goal instead is getting by and the gains he’s targeted are monumental: to shift his angle in the frame from the horizontal to the vertical and to actively participate in the special events of family life.

In this case, the word recovery takes on an entirely different meaning then it does in a high performance setting. For Falk and many others diagnosed with CFS, recovery is both tantalizing and fraught—apparent gains often manifest as trap-doors, a “Push-Crash Cycle” where routine exercise and seeming improvements deplete energy reserves and bring on a relapse of symptoms. Consequently, Falk has learned to take great care in monitoring and managing his physiological markers of fatigue.

Omegawave:Chronic Fatigue Syndrome is associated with a range of symptoms—can you describe some of the individual symptoms in your case and the impact CFS has had on your life?

John Falk: Since May 2007 (when I first came down with CFS), my symptoms have included insomnia, extremely low body temperature, dysautonomia (dysfunction of the autonomic system) and severe orthostatic problems including: an inability to adjust while going from supine to sitting or standing positions; veins that don’t constrict; blood pressure that fails to rise in a normal fashion; an inability to shiver or produce “goosebumps” when cold; and, my body only makes 80% of the blood I need to function.

In addition, the condition has caused severe cognitive impairment, particularly relative to working memory and short-term memory. I’ve been tested twice by neuropsychologists, and both measure a 50 point overall loss in IQ. On top of that, I deal with fatigue and overwhelming exhaustion—imagine not having the energy to brush your teeth, shave, walk up a set of stairs, put on socks, talk, read, play a video game, and so on.

OW: What were some of the methods you used to manage your symptoms before you began using Omegawave?

JF: I began by focusing on rest (including a forced afternoon nap)—I also switched to a Paleo diet and started monitoring my heart rate.

OW: Our technology is more commonly associated with sports & training applications—how did you learn about Omegawave and what made you decide it might be useful in managing CFS?

JF: People with CFS have a sleep disorder called “alpha wave intrusion,” a condition which results in very little recuperative delta wave (deep) sleep. To address that, I began using a technology called Zeo to analyze the parameters and phases of my sleep (alpha wave, REM, etc). That was my first foray into the “quantified self” movement, if you will. From that experience, I realized that if I could find a technology as sophisticated and useful as Zeo that could give me insights into my cardiac and autonomic systems, it could prove invaluable in managing my recovery.

I’m regularly in contact with leading researchers and journalists, but none could help me find what I felt I needed. I knew from experience that products like a Fitbit or even an HRV monitor would prove too simplistic to be truly helpful. So, I began searching online for a product that could give me reliable feedback on my autonomic and cardiac systems—eventually, my research led me to Omegawave.

OW: Which indexes do you find particularly relevant on a daily basis and how have you gone about determining your individual baselines and norms?

JF: Heart rate variability is universally disturbed in patients with CFS, usually manifesting as Sympathetic Dominance. Therefore, all cardiac system measurements are extremely valuable. I find stress, adaptation reserves, and recovery pattern the most useful as they are my best guides so I don’t overburden my body with exertion, whether physical, mental, or even emotional.

I take my measurements each morning, which are invariably low (Overall Readiness score of 1 or 2). Then, I also take a measurement at night before going to bed. If I’ve used the day wisely, my scores are—paradoxically—much higher at night than in the morning.

OW: Can you describe some of the situations in which you’ve take a specific recovery intervention based upon your Omegawave measurements?

JF: First, I use Omegawave to see how I’m responding to new sleep medications. I can tell within one to seven days if a particular med is helping me truly rest, or just making me unconscious. Second, I take thyroid medicine to address common endocrine abnormalities brought on by the CFS. With my Omegawave measurements, I am able to know if I am in a hyperthyroid state or a hypothyroid. This enables me fine-tune my dosing regimen to achieve an optimal response. Periodic blood tests have confirmed the utility of adjusting med doses according to my Omegawave readings.

In addition, general antimicrobial medications (antibiotics, antivirals, antifungals) are commonly used to suppress the smoldering infection usually plaguing a person with CFS. Using Omegawave, I can tell if I am taking too much medication for my body to properly detoxify, a situation patients often call a severe “die-off reaction.” After talking with my doctors and sharing Omegawave readings, we usually adjust dosage downwards until I am able handle the larger, more therapeutic doses.

Finally, I have discovered that by using ice baths, far infrared red saunas, and cold showers I am able to boost my parasympathetic nervous system and suppress my sympathetic system pretty much at will. It puts my body in balance and aids in my overall recovery as I am in a more restful, healing state. Usually, a simple 11-minute cold shower (50 degree Fahrenheit) takes me from an Overall Readiness score of 1 to 7, with the effect lasting 4 to 6 hours.

March 16: Low afternoon Readiness likely a result of stress caused by eating a healthy but too-large lunch (chicken & kale salad). Restful activities, hydration, and 90 minutes wearing an ice vest helped bring the afternoon assessment back to a recovered state.

OW: In addition to using Omegawave as a recovery tool, how do you plan to use the technology to begin exercising?

JF: The number one issue a CFS patient encounters during remission is a phenomenon known as the “push-crash cycle”—otherwise known as going beyond one’s “energy envelope.” For a healthy person, this would simply mean they’ve over-reached in their training and need passive rest.

Exercise is a key part in recovery, but it’s a double-edged sword. Done right, you increase the number of mitochondria and build up an ability to make and use energy more efficiently. But, if you go too far beyond your capacity, it leads to a crash—which means going back to square one and starting your recovery all over again, a process that can take weeks, months or years. Before using Omegawave, I could only go by heart rate and subjectively how I felt. So, the most critical role Omegawave plays (besides day-to-day management) is to ensure proper training during remission and recovery to stay within that crucial energy envelope.

OW: What are some of the goals you’ve set for the future and how do you think Omegawave will be able to help you achieve those goals?

JF: Taking in all of the above, my goal is nothing short of a full recovery. In 2009, I experienced a year of being fully recovered, but I overdid it—overextended myself physically, mentally, emotionally and exercised beyond my capacity. That led to my current relapse, which is going on its sixth year now.

I am, however, already exercising every-other day—either 10 push-ups or 1-3 pull-ups. But a year from now, I envision myself starting to get the upper-hand on CFS and being able to be more active. Omegawave will be critical in allowing me to build myself up without exceeding the energy envelope, like I did in 2009. In short, access to such sophisticated data and algorithms is indispensable to a recovering CFS patient—or, any patient who has to manage energy output to achieve better health.